Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

CHAPTER 316: VETERANS HEALTH ADMINISTRATION: DIALYSIS CENTER

Purpose and Scope .................................................................................................... 316-2

Definitions................................................................................................................... 316-2

Operating Rationale and Basis of Criteria ................................................................... 316-4

Program Data Required (Input Data Questions) ......................................................... 316-5

Space Criteria ............................................................................................................. 316-7

Planning and Design Considerations ........................................................................ 316-13

Functional Relationships ........................................................................................... 316-15

Functional Diagram .................................................................................................. 316-16

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

PURPOSE AND SCOPE

This document outlines Space Planning Criteria for Chapter 316: Dialysis Center. It
applies to all medical facilities at the Department of Veterans Affairs (VA).

DEFINITIONS
A. Clinic Stop: A clinic stop is one encounter of a patient with a healthcare provider.
Per these criteria, the clinic stop is the workload unit of measure for space planning.
One individual patient can have multiple Clinic Stops in a single visit or in one day.
B. Concept of Operations: A user-developed guide to the functional operation of the VA
healthcare facility. It defines the function of the facility and the scope of medical
services to be provided in the new or remodeled space.
C. Bariatrics: The branch of medicine which deals with the causes, prevention, and
treatment of obesity. The Dialysis Center must accommodate, in its equipment and
design, a high percentage of bariatric patients, many of whom are disabled or nonambulatory.
D. Dialysate: A solution of water and chemicals used in dialysis. Dialysate shall be
provided in both single-patient and multiple-patient mixtures as determined by the
medical staff.
E. Dialysis: A type of renal replacement therapy which is used to provide an artificial
replacement for lost kidney functions. There are two main forms of dialysis,
Hemodialysis and Peritoneal Dialysis, both of which are life support treatments; but
dialysis does not treat kidney diseases. Dialysis may be used for very sick patients
who have recently lost kidney functions (acute renal failure) or for stable patients who
have permanently lost kidney functions (chronic or end-stage renal failure).
F. Dialysis Center: A highly specialized program which provides facilities for the
treatment of patients with irreversible renal insufficiencies. Treatment procedures
require professional supervision by staff experienced in renal pathophysiology. The
Dialysis Center may serve either or both inpatients and outpatients, depending upon
the medical facility type, and may provide self-dialysis training for Peritoneal Dialysis
in addition to on-site assisted dialysis, i.e., Hemodialysis. The Dialysis Center
administers both single-patient and multi-patient Hemodialysis systems.
G. Full-Time Equivalent (FTE): A staffing parameter equal to the amount of time
assigned to one full time employee. It may be composed of several part-time
employees whose total time commitment equals that of a full-time employee. One
FTE equals a 40 hours per week.
H. Functional Area: The grouping of rooms and spaces based on their function within a
clinical service. Typical Functional Areas are Reception Areas, Patient Areas, Support
Areas, Staff and Administrative Areas, and Residency Program.
I.

Hemodialysis (also Haemodialysis): The form of renal dialysis typically conducted in

a Dialysis Center. Hemodialysis relies on convective transport of a dialysate and
utilizes counter-current flow, where the dialysate is flowing in the opposite direction to
blood flow in an extracorporeal circuit.
Dialysis Center (Chapter 316): Page 2 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

J. Input Data Statements: A set of questions designed to elicit information about the
healthcare project in order to create a Program for Design (PFD) based on the criteria
parameters set forth in this document. Input Data Statements could be Mission
related, based in the projects Concept of Operations; and Workload or Staffing
related, based on projections and data provided by the VHA or the VISN about the
estimated model of operation for the facility. This information is processed through
mathematical and logical operations in VA-SEPS.
K. Net-to-department gross factor (NTDG): This number, when multiplied by the
programmed net square foot (NSF) area, determines the departmental gross square
feet (DGSF) The NTDG factor adopted for Dialysis Center is 1.50.
L. Pathophysiology: The study of the disturbance of normal mechanical, physical, and
biochemical functions which a disease causes or which cause a disease.
M. Peritoneal Dialysis (PD): A form of renal dialysis typically done in the patient's home
and/or workplace. PD is based on the principle that the peritoneal membrane which
surrounds the intestine can act as a natural semi permeable membrane and that, if a
dialysate is instilled within the membrane through a catheter, intracorporeal dialysis
can occur by diffusion.
N. Program for Design (PFD): A space program based on criteria set forth in this
document and specific information about Concept of Operations, workload projections
and staffing levels authorized.
O. Room Efficiency Factor: A factor that provides flexibility in the utilization of a room to
account for patient delays, scheduling conflicts, and equipment maintenance.
Common factors are in the 80 to 85% range. A room with 80% room efficiency
provides a buffer to assume that this room would be available 20% of the time
beyond the planned operational practices of the room. This factor may be adjusted
based on the actual and/or anticipated operations and processes of the room /
department.

P. SEPS (VA-SEPS): Acronym for Space and Equipment Planning System, a digital tool
developed by the Department of Defense (DoD) and the Department of Veterans
Affairs to generate a Program for Design (PFD) and an Equipment List for a VA
healthcare project based on specific information entered in response to Input Data
Questions. VA-SEPS incorporates the propositions set forth in all VA Space Planning
Criteria chapters. VA-SEPS has been designed to aid healthcare planners in creating
a space plan based on a standardized set of criteria parameters.
Q. Water Treatment: Dialysis water treatment implies various levels of pre-treatment
and a final purification module prior to distribution of purified water through a
hydraulic circuit.
1. Deionization (DI) Water: Water which has been treated to remove contaminants.
This system removes most mineral deposits, but microbial contaminants may
remain.
2. Feed Water: The untreated, potable water available throughout the facility
through its water supply system.

Dialysis Center (Chapter 316): Page 3 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

3. Permeate Water: Fully treated purified water, stored in a tank, which is used in
the preparation of dialysate.
4. Pre-treated Water: Partially treated water, sometimes available as feed water,
which has had substantial reduction of mineral and/or microbial particles.
5. Reverse Osmosis (RO) Water: Usually the final purification module in the
treatment system, RO-based treatment modules produce water of optimal
chemical and microbial quality.
R. Workload: Workload is the anticipated number of procedures or suite stops that is
processed through a department/service area. The total workload applied to
departmental operational assumptions will determine overall room requirements by
modality.
3

OPERATING RATIONALE AND BASIS OF CRITERIA

A. Workload Projections or planned services / modalities for a specific VA medical
center, hospital, or satellite outpatient clinic project are provided by the VA Central
Office (VACO) / VISN CARES Capacity Projection Model. The workload projections
are generated by methodology based upon the expected veteran population in the
respective market/service area. Healthcare planners working on VA medical center,
hospital, or satellite outpatient clinic projects will utilize and apply the workload criteria
set forth herein for identified services and modalities to determine room requirements
for each facility.
B. Space planning criteria have been developed on the basis of an understanding of the
activities involved in the functional areas of the Dialysis Center and its relationship
with other services of a medical facility. These criteria are predicated upon
established and/or anticipated best practice standards, as adapted to provide
environments supporting the highest quality heath care for Veterans.
C. These criteria are subject to modification relative to development in the equipment,
medical practice, vendor requirements, and subsequent planning and design. The
selection of the size and type of Dialysis Center equipment is determined by VACO
and based upon Veterans Health Administration (VHA) anticipated medical needs.
D. Dialysis Center capacity per year should be based on:
Operating days per year x Hours of operation per day
Minutes per clinic stop / 60 minutes

= Number of
annual clinic stops

1. Although the general planning model for VA dialysis facilities assumes 365
Operating Days per Year and 24 Hours of Operation per Day to support Inpatient
Programs, these criteria are based upon that Inpatient dialysis will occur in
Inpatient Units rather than in the Dialysis Center; and the impact of such within
the Dialysis Center will be on staffing, supplies, storage, and equipment
processing rather than on the number of Dialysis Center Dialysis Stations.
2. For Outpatient Treatment, the Dialysis Center will operate on a different schedule,
including only select days of the week and hours of the day. Dialysis Station
capacity will fluctuate during hours of operation, i.e., peak hours generally will
Dialysis Center (Chapter 316): Page 4 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

demonstrate a high utilization rate; and off-peak hours, generally the first and last
operating hours per day, will generate a lower rate.
3. The basic Room Efficiency Factors for Dialysis Stations are 90% use during the
peak hours of operation, including the time between patient use when staff
members are preparing the space, and 80% use during the off-peak hours of
operation. Use 85% use as the mean which indicates that, on average for each
Outpatient Dialysis Station in the VA system through the course of all operating
hours, a Dialysis Station is prepared and ready for use but unoccupied 10% of the
available time. This is the basis for determining a system-wide design standard
for calculating the number of Dialysis Stations required.
Example: Assume the operating averages for VA Dialysis Centers are 6 days
a week and 10 hours a day. Also assume each Dialysis Station use averages
300 minutes (5 hours) per clinic stop, including clean-up and set-up:
6 operating days per week X 52 weeks per year = 312 operating days per
year.
312 operating days per year x 10 hours of operation per day
= 624 annual
300 minutes per clinic stop / 60 minutes
clinic stops
This yields a maximum capacity of 624 clinic stops per year per Dialysis
Station, assuming 100% utilization. However, 100% utilization is not realistic
to achieve; thus, it is not realistic as a design standard. Apply the Room
Efficiency Factor as follows:
624 x 85% = 530 annual clinic stops.
TABLE 1: WORKLOAD PARAMETER CALCULATION

DIALYSIS CENTER
Dialysis Station

AVERAGE
LENGTH OF
CLINIC STOP
(minutes)
300

UTILIZATION
RATE
90%

MINIMUM
WORKLOAD
TO GENERATE
ONE DIALYSIS
STATION
530

The number of annual clinic stops per dialysis station will be used as a criteria
parameter to calculate the number of Dialysis Stations.
4

PROGRAM DATA REQUIRED (Input Data Questions)

A. Mission Input Data Statements:
1 Is a Single-Patient Dialyzer (Special Mix) System authorized? (M)
2 Is a Multi-Patient Dialyzer (Central Batch Delivery) System authorized? (M)
3 Is a Self-Dialysis Training Program authorized? (M)
4 Is a Peritoneal Dialysis Program authorized? (M)
5 Is a Transplant Follow-up Program authorized? (M)
6 Is the Dialysis Center authorized to provide mobile dialysis at remote locations
within the medical facility? (M)
7 Is a Dialysis Center Biochemistry Laboratory authorized? (M)
Dialysis Center (Chapter 316): Page 5 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

8
9

Is water-softening equipment authorized? (M)

Is a Dialysis Equipment Repair Shop authorized? (M)\Is an automated Medication
Dispensing System authorized? (M)
10 Is Mobile Dialysis authorized? (M)
B. Workload Input Data Statements:
1 How many annual Dialysis Center Clinic stops are projected? (W)
2 How many daily Self-dialysis / Peritoneal Dialysis consultation patients are
projected? (W)
3 How many daily Transplant Follow-up consultation patients are projected? (W)
C. Staffing Input Data Statements:
1 How many Assistant Chief of Service FTE positions are authorized? (S)
2 How many Physician FTE positions are projected? (S)
3 How many PA FTE positions are authorized? (S)
4 How many Resident FTE positions are authorized? (S)
5 How many Intern FTE positions are authorized? (S)
6 How many Executive Secretary FTE positions are authorized? (S)
7 How many Clerical FTE positions are authorized? (S)
8 How many Social Worker FTE positions are authorized? (S)
9 How many Chief Chemist FTE positions are authorized? (S)
10 How many Assistant Chemist FTE positions are authorized? (S)
11 How many Chief Nurse FTE positions are authorized? (S)
12 How many Assistant Nurse FTE positions are authorized? (S)
13 How many Chief Dietitian FTE positions are authorized? (S)
14 How many Assistant Dietitian FTE positions are authorized? (S)
15 How many Education Coordinator FTE positions are authorized? (S)
16 How many Assistant Education Coordinator FTE positions are authorized? (S)
17 How many Student / Trainee FTE positions are authorized? (S)
18 How many Dialysis Support Technician FTE positions are authorized? (S)
19 How many Lab Technician FTE positions are authorized? (S)
20 How many Dialysis Lead Technician FTE positions are authorized? (S)
D. Miscellaneous Input Data Statements:
1 How many Negative Pressure (Contagious or Infectious) Isolation Dialysis Rooms
are authorized? (Misc)
2 Is a Private or Blood borne Isolation (Behavioral Disorder, HIV/AIDS, Hepatitis, or
"VIP") Dialysis Room authorized? (Misc)
3 What is the percentage of all patients who will use reclining chairs rather than
beds or stretchers? (Misc)
4 Are disposable filters authorized? (Misc)
5 Are clean and sterile supplies prepackaged and distributed from a Clean Supply
Storage Room? (Misc)
6 Is Standard Furniture authorized? (Misc)
7 Are patient lockers authorized? (Misc)
8 How many FTEs will work on peak shift? (Misc)
9 How many FTE positions are not authorized to have office or cubicle space?
(Misc)

Dialysis Center (Chapter 316): Page 6 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

SPACE CRITERIA
A. Reception Areas
1

Waiting (WRC01) ..................................................................200 NSF (18.6 NSM)

Minimum NSF; provide an additional 55 NSF per each projected Dialysis Station
greater than five.
200 NSF provides for six standard seats, two wheelchair accessible seat, and
waiting space for one stretcher or two personal scooters. The additional 55 NSF
allocates 25 NSF for one accessible seat and 30 NSF for two standard seats.

Reception (RECP1) ..................................................................80 NSF (7.5 NSM)

Minimum NSF; provide an additional 10 NSF for every increment of two Dialysis
Stations greater than eight; maximum 150 NSF.

Toilet, Public (TLTU1) ..............................................................50 NSF (4.7 NSM)

Provide one for male and one for female.

B. Patient Areas
1

Renal Dialysis, Bed Station, Private (XXYYZ) .................... 150 NSF (14.0 NSM)
Provide one per Dialysis Center if authorized.
Private Bed Stations are enclosed rooms, though still visually and audibly
observable from the Nurse Station, for patients requiring singular privacy or blood
borne infection isolation but not airborne infection isolation. These rooms
accommodate patients who might agitate other patients, or be caused anxiety by
others, or who are known to have blood borne pathogens.

Renal Dialysis, Bed Station,

Isolation, Negative Pressure (RDC02) ................................ 150 NSF (14.0 NSM)
Provide one per Negative Pressure Isolation Bed Station if authorized.
These rooms isolate airborne contagious or infectious patients to protect other
patients and should be allocated on a per-project basis.

Renal Dialysis, Chair Station, Cubicle (RDC01) .....................80 NSF (7.5 NSM)
Divide the projected number of annual Dialysis Center Clinic Stops by 530;
subtract the number of Private and / or Isolation Bed Stations from the total; and
multiply the result by the percentage of all patients who will use a reclining chair;
provide one for every whole increment, minimum fraction of 0.1.
Cubicle Chair Stations are the most common Dialysis Station. They include a
mobile reclining chair and are not enclosed rooms.

Renal Dialysis, Bed Station, Cubicle (XXYYZ) .....................100 NSF (9.3 NSM)
Divide the projected number of annual Dialysis Center Clinic Stops by 530 and
subtract the number of Private and / or Isolation Bed Stations and the number of
Cubicle Chair Stations from the total; provide one for every whole increment,
minimum fraction of 0.1.

Dialysis Center (Chapter 316): Page 7 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

Cubicle Bed Stations are usually open for patients who arrive stretcher- or bedbound but do not require isolation or singular privacy. These are not enclosed
rooms.
5

Exam / Treatment Room (TRGM1) ...................................... 120 NSF (11.2 NSM)

Provide one per Dialysis Center.
This room is used for physical exams prior to treatment; to implant cannulas; to
remove clots from shunts; and to perform special examinations, treatment, or
kidney biopsies.

Exam, Transplant Follow-up (EXRG3) ................................ 120 NSF (11.2 NSM)

Provide one if a Transplant Follow-up Program is authorized; provide an
additional one if the projected number of daily Transplant Follow-up consultation
patients is fifteen or greater.

Training Room, Dialysis (RDC01) ....................................... 120 NSF (11.2 NSM)

Provide one if a Self-Dialysis or Peritoneal Training Program is authorized;
provide an additional one if the number of projected daily Self-Dialysis and / or
Peritoneal consultation patients is ten or greater.

Toilet, Patient (TLTU1) ............................................................. 50 NSF (4.7 NSM)

Provide one per Nurse Station.
If a Biochemistry Lab is authorized, patient toilets shall be used to pass
specimens into the lab.

Toilet, Patient, Private (TLTU1) ............................................... 50 NSF (4.7 NSM)

Provide one per Private Bed Station.

10 Toilet, Patient, Isolation (TLTU1) ............................................ 50 NSF (4.7 NSM)

Provide one per Isolation Bed Station.
11 Locker Room, Patient (LR001) ................................................ 50 NSF (4.7 NSM)
Minimum NSF; provide an additional 6 NSF per Cubicle Bed or Chair Station.
C. Support Areas
1

Utility Room, Soiled (USCL1) .................................................. 80 NSF (7.5 NSM)

Minimum NSF; provide one per Dialysis Center; provide an additional 20 NSF per
Nurse Station greater than one.

Utility Room, Clean (UCCL1) ................................................ 100 NSF (9.3 NSM)

Minimum NSF; provide one per Dialysis Center if prepackaged clean and sterile
supplies are not authorized; provide an additional 10 NSF per Nurse Station
greater than one.

Storage, Clean Supply (SRS01) .............................................. 80 NSF (7.5 NSM)

Minimum NSF; provide one per Dialysis Center; provide an additional 20 NSF per
Nurse Station greater than one; provide an additional 20 NSF if Mobile Dialysis is
authorized.

Dialysis Center (Chapter 316): Page 8 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

This room accommodates one weeks supply of disposable and non-sterile

supplies such as, but not limited to: dialysate acid concentrate, dialysate
bicarbonate, vinegar, bleach, dialyzers, blood lines, and plastic aprons. An
additional two weeks supply of such should be maintained in the Hospital /
Medical Center Warehouse. See Chapter 291.
4

Storage, Sterile Supply (SRSE1) .............................................80 NSF (7.5 NSM)

Minimum NSF; provide one per Dialysis Center if prepackaged sterile supplies are
authorized; provide an additional 20 NSF per Nurse Station greater than one;
provide an additional 20 NSF if Mobile Dialysis is authorized.

Storage, Clean Linen (LCCL1) .................................................40 NSF (3.8 NSM)

Minimum NSF; provide one per Dialysis Center; provide an additional 10 NSF per
each Nurse Station greater than one.

Storage, Equipment (SRE01) .................................................100 NSF (9.3 NSM)

Minimum NSF; provide one per Dialysis Center and an additional 20 NSF for each
Nurse Station greater than one.

Nourishment Station (NCWD1)............................................ 120 NSF (11.2 NSM)

Provide one per Dialysis Center.

Medication Preparation (MEDP1) ........................................ 110 NSF (10.3 NSM)

Minimum NSF; provide one per Dialysis Center; provide an additional 10 NSF if
an automated medication dispensing system is authorized.

Alcove, Crash Cart (RCA01) ....................................................20 NSF (1.9 NSM)

Provide one per Dialysis Center.

10 Laboratory, Biochemistry (LMCH1) .................................... 180 NSF (16.8 NSM)

Provide one per Dialysis Center if authorized.
This area minimally includes urine and blood chemical analyzers and an
undercounter refrigerator.
11 Laboratory, Venipuncture (LBVP1) .........................................80 NSF (7.5 NSM)
Provide one per Dialysis Center if a Dialysis Center Biochemistry Lab is
authorized.
This room must be located adjacent to the lab and must be easily accessible to
patients. The phlebotomy chair must be suitable for bariatric patients.
12 Equipment Processing, Soiled Receiving (CSDE1) ........... 150 NSF (14.0 NSM)
Minimum NSF; provide an additional 5 NSF per Dialysis Station greater than ten;
provide an additional 50 NSF if Mobile Dialysis is authorized; maximum 250 NSF.
This room is the first component of a threefold process in the one-way flow of reusable materiel from soiled to clean and accommodates soiled holding,
decontamination, and washing functions.
13 Equipment Processing, Clean Preparation (CSSS1) ......... 200 NSF (18.6 NSM)
Provide one per Dialysis Center; provide an additional 50 NSF if Mobile Dialysis is
authorized.
Dialysis Center (Chapter 316): Page 9 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

This room is the second component of a threefold process in the one-way flow of
re-usable materiel from soiled to clean and accommodates sorting, sterilizing,
assembly, repackaging, and labeling functions.
14 Equipment Processing, Clean Storage (CSIA1)................. 200 NSF (18.6 NSM)
Minimum NSF; provide an additional 10 NSF per Dialysis Station greater than
fifteen; provide an additional 50 NSF if Mobile Dialysis is authorized; provide an
additional 20 NSF if disposable filters are used; maximum 300 NSF.
This room is the third component of a threefold process in the one-way flow of reusable materiel from soiled to clean and accommodates storage, including
refrigerated storage and, if authorized, mobile dialysis equipment.
15 Equipment Processing, Repair Shop (BMER1).................. 150 NSF (14.0 NSM)
Provide one per Dialysis Center if authorized.
16 Dialysate Preparation Room (MEDP1)............................... 150 NSF (14.0 NSM)
Minimum NSF; provide an additional 50 NSF if a Single-patient Dialyzer (Special
Mix) System is authorized, and / or an additional 100 NSF if a Multiple-patient
Dialyzer (Central Batch Delivery) System is authorized; provide an additional 5
NSF for each projected Dialysis Station greater than ten; maximum 300 NSF.
17 Water Treatment Room (RDWT1) ....................................... 200 NSF (18.6 NSM)
Minimum NSF; provide an additional 10 NSF if water-softening equipment is
authorized; provide an additional 5 NSF per Dialysis Station greater than ten;
maximum 240 NSF if water softener is not authorized; maximum 250 NSF if water
softener is authorized.
This room accommodates the equipment and supplies, including consumable
products, for all dialysis-required forms of water treatment.
18 Alcove, Wheelchair / Stretcher (SRLW1) .............................. 50 NSF (37.2 NSM)
Minimum NSF; provide an additional 5 NSF per Dialysis Station greater than ten;
maximum of 100 NSF.
This space must accommodate non-folding bariatric type wheelchairs in addition
to standard folding wheelchairs and, occasionally, a transport stretcher or a
mobile dialysis chair which has been moved temporarily from a cubicle to
accommodate a patients bed or stretcher. Most patients who arrive stretcher- or
bed-bound do not transfer to chairs or another stretcher or bed during their
dialysis procedure.
19 Housekeeping Aids Closet HAC (JANC1) ......................... 50 NSF (37.2 NSM)
Minimum NSF; provide an additional 5 NSF for each projected Dialysis Station
greater than ten; maximum of 100 NSF.
D. Staff and Administrative Areas
1

Nurse Station (NSTA1) ........................................................ 110 NSF (10.3 NSM)

Minimum NSF; provide one for each increment of ten Dialysis Stations; provide an
additional 15 NSF per Dialysis Station greater than four; maximum 200 NSF.

Dialysis Center (Chapter 316): Page 10 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

Office, Chief of Service (OFA01) ......................................... 150 NSF (14.0 NSM)

Provide one per Dialysis Center.

Office, Assistant Chief of Service (OFA01 / OFA02) .......... 120 NSF (11.2 NSM)
Provide one per Assistant Chief of Service FTE position authorized; provide
OFA01 if standard furniture is authorized or OFA02 if systems furniture is
authorized.

Office, Executive Secretary and Waiting (SEC01).............. 120 NSF (11.2 NSM)
Provide one per Executive Secretary FTE position authorized.

Office, Physician (OFD03) ...................................................120 NSF (11.2 NSM)

Provide one per Physician FTE position authorized.

Office, PA / Resident / Intern (OFD03) ................................ 120 NSF (11.2 NSM)

Provide one per PA / Resident / Intern FTE position authorized.

Office, Chief Nurse (OFA01 / OFA02) .................................. 120 NSF (11.2 NSM)
Provide one per Chief Nurse FTE position authorized; provide OFA01 if standard
furniture is authorized or OFA02 if systems furniture is authorized.

Office, Chief Chemist (OFA01 / OFA02) .............................. 120 NSF (11.2 NSM)
Provide one per Chief Chemist FTE position authorized; provide OFA01 if
standard furniture is authorized or OFA02 if systems furniture is authorized.

Office, Chief Dietician (OFA01 / OFA02) ............................. 120 NSF (11.2 NSM)
Provide one per Chief Dietician FTE position authorized; provide OFA01 if
standard furniture is authorized or OFA02 if systems furniture is authorized.

10 Office, Social Worker (OFA01 / OFA02) .............................. 120 NSF (11.2 NSM)
Provide one per Social Worker FTE position authorized; provide OFA01 if
standard furniture is authorized or OFA02 if systems furniture is authorized.
11 Office, Education Coordinator (OFA01 / OFA02) ............... 120 NSF (11.2 NSM)
Provide one per Education Coordinator FTE position authorized; provide OFA01 if
standard furniture is authorized or OFA02 if systems furniture is authorized.
12 Cubicle, Clerical (OFA03) ........................................................60 NSF (5.6 NSM)
Provide one per Clerical FTE position authorized.
13 Cubicle, Assistant Chemist (OFA03) ......................................60 NSF (5.6 NSM)
Provide one per Assistant Chemist FTE position authorized.
14 Cubicle, Assistant Dietician (OFA03)......................................60 NSF (5.6 NSM)
Provide one per Assistant Dietician FTE position authorized.
15 Cubicle, Assistant Education Coordinator (OFA03) ..............60 NSF (5.6 NSM)
Provide one per Assistant Education Coordinator FTE position authorized.
16 Cubicle, Dialysis Lead Technician (OFA03) ...........................60 NSF (5.6 NSM)
Provide one per Dialysis Lead Technician FTE position authorized.
17 Cubicle, Student / Trainee (OFA03).........................................30 NSF (2.8 NSM)
Dialysis Center (Chapter 316): Page 11 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

Provide one per Student / Trainee position authorized and on duty during peak
hours.
18 Cubicle, Dialysis Support Technician (OFA03)...................... 30 NSF (2.8 NSM)
Provide one for every increment of two Dialysis Support Technician FTE positions
authorized; provide one additional cubicle if a Dialysis Equipment Repair Shop is
authorized.
19 Cubicle, Lab Technician (OFA03) ........................................... 30 NSF (2.8 NSM)
Provide one for each two Lab Technician FTE positions authorized.
20 Conference Room (CRA01) ................................................ 300 NSF (29.9 NSM)
Provide one per Dialysis Center.
21 Classroom (CRR01) ............................................................ 300 NSF (27.9 NSM)
Provide one per Dialysis Center if an Education Coordinator is authorized.
D. Staff and Administrative Areas
The spaces below provide programming of Lounge, Lockers, and Toilets at
department/service/chapter level. Alternatively, sum all departments/services data for
Lockers, Lounges and Toilets, and program space in Chapter 410-EMS Lockers,
Lounges, Toilets and Showers. Either/or do not duplicate space. Provide locker
space only for those FTEs without office or cubicle space.
1. Lounge, Staff (SL001) .............................................................. 80 NSF (7.5 NSM)
Minimum NSF; provide an additional 15 NSF per each FTE position authorized
greater than five; maximum 210 NSF.
For less than five FTE combine Lounge facilities with adjacent department or
sum in chapter 410.
2. Locker Room, Staff (LR001) .................................................... 80 NSF (7.5 NSM)
Minimum NSF if number of FTE positions for whom office space is not authorized
is between five and thirteen; provide an additional 6 NSF per FTE position
authorized for whom office space is not authorized greater than thirteen.
Provide locker space only for those FTEs without assigned office or cubicle
space. For less than five FTE combine Locker Room facilities with adjacent
department or sum in chapter 410.
3. Toilet, Staff (TLTU1) ................................................................. 50 NSF (4.7 NSM)
Minimum one; provide an additional staff toilet for each increment of five FTE
positions authorized greater than thirteen.
6

PLANNING AND DESIGN CONSIDERATIONS

A. Net-to-department gross factor (NTDG) for Dialysis Center is 1.50. This number,
when multiplied by the programmed net square foot (NSF) area, determines the
departmental gross square feet.
B. Outpatients shall have convenient access to the Dialysis Center from parking areas
and public transportation. Inpatients should have a secluded access which
Dialysis Center (Chapter 316): Page 12 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

accommodates the passage of bariatric size patient transport devices.

C. Refer to the latest edition of the Guidelines for the Design and Construction of Health
Care Facilities published by and available from the American Institute of Architects,
1735 New York Avenue, NW, Washington DC 20006.
D. The Nurse Station(s) must have a clear visual line of observation of each patient
station and each patient toilet room entrance. Each Nurse Station shall observe no
more than ten patient stations; and, when multiple Nurse Stations are required, they
shall be arranged to each observe as equal a share of the Dialysis Stations as
possible.
E. Dialysis patients are highly susceptible to infections. Set the Dialysis Center in an
area which will prevent cross-flow by other patients and staff; provide strategically
placed and accessible hand washing stations throughout the patient treatment areas;
and locate each dialysate return receptacle on the wall, centered at each patient
station, and at a height such that it is easily accessible to clean repeatedly each day.
F. Provide 4-0 (1.22m) minimum clearance between beds or chairs and a headwall at
each Dialysis Station at least 10-9 (3.28m) wide
G. The height of the dialysate receptacle shall be coordinated with the equipment and
the preceding parameter to inhibit an excessively long dialysate return hose; and any
architectural systems used to conceal the gravity drain must be easily removable
such as not to impede decontamination or modifications.
H. Dialysis patients are highly sensitive to and adversely affected by unsteady ranges of
temperature, pressure, and humidity. Environmental systems must provide stable,
consistent conditions.
I.

If the Dialysis Center Biochemistry Laboratory is not authorized, the blood and urine
analyses must be performed by the Clinical Laboratory of the Medical Facility, and
proximity must be considered as shown in the Functional Relationships Matrix below.

J. If the Dialysis Center Biochemistry Laboratory is authorized, locate patient toilets

adjacent to the lab, and provide a pass-through into the lab.
K. Patient confidentiality must be maintained when providing personal information to
interview clerks and/or other staff. The physical design of the space shall not
encumber this requirement.
L. Locate staff areas to be convenient to staff and separate from patient areas, and
segregate patient and staff circulations. Since the Dialysis Center operates 24 hours
a day / 365 days a year, its Staff Lounge, Staff Lockers, Staff Toilets, and Staff
Showers should not be collocated with those of adjacent departments unless they are
in close proximity and always accessible to the Dialysis Center staff.
M. Dialysis equipment may connect directly into patient data information systems to input
recordings of the treatment process. The designer must coordinate the interface of
the equipment and the information system.

Dialysis Center (Chapter 316): Page 13 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

FUNCTIONAL RELATIONSHIPS
Relationship of Dialysis Center to services listed below:
TABLE 2: FUNCTIONAL RELATIONSHIP MATRIX
SERVICES

RELATIONSHIP

REASON

Ambulatory Care

Ambulatory Entrance

Cardiovascular Laboratories

Engineering Services

Biomedical Engineering Repair Shop

Pulmonary Medicine

Laboratory Service

Medical Administrative Service

Patient Care Units CCU

Patient Care Units MICU

Patient Care Units General Medical

Patient Care Units Respiratory Care

Parking Facilities

Pharmacy Main

Supply Service (Sterile Processing Dept.)

Rehabilitation Medical Service

Legend:

Reasons:

Relationship

(Use as many as appropriate)

1. Adjacent
2. Close / Same Floor
3. Close / Different Floor
Acceptable
4. Limited Traffic
X. Separation Desirable

A. Common use of resources

B. Accessibility of supplies
C. Urgency of contact
D. Noise or vibration
E. Presence of odors or fumes
F. Contamination hazard
G. Sequence of work
H. Patients convenience
I. Frequent contact
J. Need for security
K. Others (specify)

Dialysis Center (Chapter 316): Page 14 of 15

Department of Veterans Affairs

Washington, D.C. 20402

VA Space Planning Criteria (316)

March 2008 (SEPS Version 1.6)

FUNCTIONAL DIAGRAM

Dialysis Center (Chapter 316): Page 15 of 15